Hepatocellular carcinoma: again, tobacco is the first enemy.

摘要

Worldwide, hepatocellular carcinoma (HCC) is the fifth most common cancer and is the third most common cause of cancer mortality. Early detection and treatment are not evidence based and lack significant impact on mortality.1 In contrast, HCC's burden can be easily reduced by policies to reduce the population's exposure to known aetiological agents (e.g. discouraging alcohol consumption and promoting hepatitis B vaccination), or early therapeutic intervention for 'at-risk' individuals before development of cirrhosis.Lee et al. confirmed the relationship between cigarette smoking and liver cancer and are questioning the US Surgeon General's conclusion that the data are suggestive but not sufficient.2'3 Indeed, the US Surgeon General's conclusion is surprising because Zhu et al.4 demonstrated that, even in a country with low risk of liver cancer, such as the USA, cigarette smoking is a dose-related contributing factor.